RESUMO
BACKGROUND: A percutaneous kidney biopsy (PKB) allows nephrologists to make informed decisions for treating various kidney diseases; however, the risk of bleeding complications should be considered, given the vascularity of the kidney. Many studies have reported risk factors for bleeding events after a PKB. However, while urinary N-acetyl-ß-D-glucosaminidase (NAG) is a useful biomarker of kidney disease severity, little is known about whether or not urinary NAG is related to the bleeding risk. METHODS: Medical records of patients who underwent a PKB at the National Defense Medical College Hospital between October 2018 and October 2023 were retrospectively studied. Hemoglobin (Hb) loss ≥ 1 g/dL was defined as a bleeding event. RESULTS: Of the 213 patients, 110 (51.6%) were men, and the median age was 56 years old (interquartile range 40-71). The most frequent diagnosis on a PKB was IgA nephropathy (N = 72; 34.0%). Fifty-four patients (25.3%) experienced Hb loss ≥ 1 g/dL after a PKB, and urinary NAG/Cr levels before the biopsy were able to predict a bleeding event, with an area under the receiver operating characteristic curve of 0.65 (p = 0.005). Using the optimal cutoff value of 35 U/gCr, urinary NAG/Cr was found to be an independent risk factor by multiple logistic regression analysis (odds ratio 3.21, 95% confidence interval 1.42-7.27, p = 0.005). Even after adjusting for previously-reported risk factors, the elevated urinary NAG/Cr ratio remained a statistically significant variable. Compared with the pathological findings, only the severity of multilayered elastic laminae of the small muscular artery was associated with both urinary NAG/Cr levels (p = 0.008) and bleeding events (p = 0.03). CONCLUSION: Urinary NAG successfully predicted not only the severity of kidney disorders but also bleeding events after a PKB. Arteriosclerosis in the kidneys may be the mechanism underlying these increased bleeding events.
Assuntos
Acetilglucosaminidase , Rim , Humanos , Acetilglucosaminidase/urina , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Idoso , Adulto , Rim/patologia , Biópsia , Biomarcadores/urina , Valor Preditivo dos Testes , Hemorragia Pós-Operatória/etiologia , Hemorragia Pós-Operatória/urina , Nefropatias/urina , Nefropatias/patologia , Nefropatias/etiologia , Nefropatias/diagnóstico , Hemorragia/etiologia , Hemorragia/urinaRESUMO
Urinary cadmium (U-Cd) values are indicators for determining chronic cadmium toxicity, and previous studies have calculated U-Cd indicators using renal injury biomarkers. However, most of these studies have been conducted in adult populations, and there is a lack of research on U-Cd thresholds in preschool children. We aimed to apply benchmark dose (BMD) analysis to estimate the U-Cd threshold level associated with renal impairment in preschool children in the cadmium-polluted area. 518 preschool children aged 3-5 years were selected by systematic sampling (275 boys, 243 girls). Urinary cadmium and three biomarkers of early renal injury (urinary N-acetyl-ß-D-glucosaminidase, UNAG; urinary ß2-microglobulin, Uß2-MG; urinary retinol-binding protein, URBP) were determined. Bayesian model averaging estimated the BMD and lower confidence interval limit (BMDL) of U-Cd. The medians U-Cd levels in both boys and girls exceeded the recommended national standard threshold (5 µg/g cr) and U-Cd levels were higher in girls than in boys. Urinary N-acetyl-ß-D-glucosaminidase (UNAG) was the most sensitive biomarker of renal effects in preschool children. The overall BMDL5 (BMDL at a benchmark response value of 5) was 2.76 µg/g cr. In the gender analysis, the BMDL5 values were 1.92 µg/g cr for boys and 4.12 µg/g cr for girls. This study shows that the U-Cd threshold (BMDL5) is lower than the national standard (5 µg/g cr) and boys' BMDL5 was lower than the limit set by the European Parliament and Council in 2019 (2 µg/g cr), which provides a reference point for making U-Cd thresholds for preschool children.
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Teorema de Bayes , Biomarcadores , Cádmio , Humanos , Pré-Escolar , Masculino , Feminino , Cádmio/urina , Biomarcadores/urina , Poluentes Ambientais/urina , Acetilglucosaminidase/urina , Benchmarking , Exposição Ambiental , Microglobulina beta-2/urina , Proteínas de Ligação ao Retinol/urina , Monitoramento Ambiental/métodosRESUMO
INTRODUCTION: Tachycardia caused by sympathetic overactivity impairs myocardial function and raises septic patients' mortality. This study examined whether tachycardia is associated with acute kidney injury (AKI) period-prevalence among critically ill patients with and without sepsis. METHODS: In 328 patients (119 sepsis and 209 non-sepsis) admitted to our intensive care unit (ICU), we assessed heart rate at ICU admission, plasma neutrophil gelatinase-associated lipocalin (NGAL) and N-terminal pro-B-type natriuretic peptide, and urinary L-type fatty acid-binding protein and N-acetyl-ß-
Assuntos
Injúria Renal Aguda , Estado Terminal , Sepse , Taquicardia , Humanos , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/sangue , Sepse/complicações , Taquicardia/etiologia , Taquicardia/complicações , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Prospectivos , Idoso , Biomarcadores/sangue , Biomarcadores/urina , Unidades de Terapia Intensiva , Lipocalina-2/sangue , Lipocalina-2/urina , Frequência Cardíaca , Proteínas de Fase Aguda/urina , Prevalência , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Acetilglucosaminidase/urinaRESUMO
PURPOSE: Urinary biomarkers are known to be able to diagnose renal damage caused by obstruction at an early stage. We evaluated the usefulness of urine N-acetyl-beta-D-glucosaminidase (NAG) to determine the prognosis of antenatal hydronephrosis. MATERIALS AND METHODS: From January 2019 to December 2021, a retrospective study was performed on patients with grade 3 or 4 hydronephrosis. We analyzed the ultrasonographic findings and the urinary NAG/Cr ratio between the laparoscopic pyeloplasty (LP) group and active surveillance (AS) group. RESULTS: A total of 21 children underwent LP for ureteropelvic junction (UPJ) obstruction and 14 children underwent AS. The mean age at the time of examination was 3.7 months (1.7-7.5 months) in the LP and 5.2 months (0.5-21.5 months) in the AS (p=0.564). The mean anteroposterior pelvic diameter was 30.0 mm (15.0-49.0 mm) in the LP and 16.7 mm (9.0-31.3 mm) in the AS (p=0.003). The mean renal parenchymal thickness was 2.6 mm (1.2-3.7 mm) in the LP and 3.8 mm (2.9-5.5 mm) in the AS (p=0.017). The urinary NAG/Cr ratio was 26.1 IU/g (9.8-47.4 IU/g) in the LP and 11.1 IU/g (2.6-18.1 IU/g) in the AS (p=0.003). After LP, the urinary NAG/Cr ratio was significantly reduced to 10.4 IU/g (3.4-14.2 IU/g) (p=0.023). CONCLUSIONS: The urinary NAG/Cr ratio, one of the biomarkers of acute renal injury, is closely related to the degree of hydronephrosis. Therefore, it may be useful to determine whether to perform surgery on the UPJ obstruction and to predict the prognosis.
Assuntos
Acetilglucosaminidase , Biomarcadores , Hidronefrose , Humanos , Acetilglucosaminidase/urina , Hidronefrose/urina , Hidronefrose/diagnóstico por imagem , Hidronefrose/etiologia , Estudos Retrospectivos , Prognóstico , Lactente , Feminino , Masculino , Biomarcadores/urina , Valor Preditivo dos Testes , Obstrução Ureteral/urina , Obstrução Ureteral/diagnóstico por imagem , Obstrução Ureteral/complicações , Obstrução Ureteral/cirurgiaRESUMO
BACKGROUND: Epidemiological studies have reported associations between heavy metals and renal function. However, longitudinal studies are required to further validate these associations and explore the interactive effects of heavy metals on renal function and their directional influence. METHOD: This study, conducted in Northeast China from 2016 to 2021, included a four-time repeated measures design involving 384 participants (1536 observations). Urinary concentrations of chromium (Cr), cadmium (Cd), manganese (Mn), and lead (Pb) were measured, along with renal biomarkers including urinary microalbumin (umAlb), urinary albumin-to-creatinine ratio (UACR), N-acetyl-ß-D-glucosaminidase (NAG), and ß2-microglobulin (ß2-MG) levels. Estimated glomerular filtration rate (eGFR) was calculated. A Linear Mixed Effects Model (LME) examined the association between individual metal exposure and renal biomarkers. Subsequently, Quantile g-computation and Bayesian Kernel Machine Regression (BKMR) models assessed the overall effects of heavy metal mixtures. Marginal Effect models examined the directional impact of metal interactions in the BKMR on renal function. RESULT: Results indicate significant impacts of individual and combined exposures of Cr, Cd, Pb, and Mn on renal biomarkers. Metal interactions in the BKMR model were observed, with synergistic effects of Cd-Cr on NAG, umAlb, UACR; Cd-Pb on NAG, UACR; Pb-Cr on umAlb, UACR, eGFR-MDRD, eGFR-EPI; and an antagonistic effect of Mn-Pb-Cr on UACR. CONCLUSION: Both individual and combined exposures to heavy metals are associated with renal biomarkers, with significant synergistic interactions leading to renal damage. Our findings elucidate potential interactions among these metals, offering valuable insights into the mechanisms linking multiple metal exposures to renal injury.
Assuntos
Biomarcadores , Metais Pesados , Metais Pesados/toxicidade , Metais Pesados/urina , Humanos , China/epidemiologia , Masculino , Biomarcadores/urina , Feminino , Estudos Longitudinais , Pessoa de Meia-Idade , Adulto , Poluentes Ambientais/toxicidade , Taxa de Filtração Glomerular/efeitos dos fármacos , Exposição Ambiental/efeitos adversos , Rim/efeitos dos fármacos , Cádmio/toxicidade , Cádmio/urina , Acetilglucosaminidase/urina , Microglobulina beta-2/urina , Monitoramento AmbientalRESUMO
Urinary biomarkers can predict the progression of chronic kidney disease (CKD). In this study, kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and N-acetyl-β-D-glucosaminidase (NAG) were correlated with the stages of CKD, and the association of these biomarkers with CKD progression and adverse outcomes was determined. A total of 250 patients, including 111 on hemodialysis, were studied. Urinary KIM-1, NGAL, and NAG were measured at baseline. Patients not on dialysis at baseline who progressed to a worse CKD stage were compared with those who did not progress. The association of each biomarker and selected covariates with progression to more advanced stages of CKD, end-stage kidney disease, or death was evaluated by Poisson regression. NGAL was moderately correlated (rs=0.467, P<0.001) with the five stages of CKD; KIM-1 and NAG were also correlated, but weakly. Sixty-four patients (46%) progressed to a more advanced stage of CKD. Compared to non-progressors, those patients exhibited a trend to higher levels of KIM-1 (P=0.064) and NGAL (P=0.065). In patients not on dialysis at baseline, NGAL was independently associated with progression of CKD, ESKD, or death (RR=1.022 for 300 ng/mL intervals; CI=1.007-1.037, P=0.004). In patients on dialysis, for each 300-ng/mL increase in urinary NGAL, there was a 1.3% increase in the risk of death (P=0.039). In conclusion, urinary NGAL was associated with adverse renal outcomes and increased risk of death in this cohort. If baseline urinary KIM-1 and NGAL predict progression to worse stages of CKD is something yet to be explored.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Acetilglucosaminidase/urina , Receptor Celular 1 do Vírus da Hepatite A/análise , Lipocalina-2/urina , Insuficiência Renal Crônica/patologia , Insuficiência Renal Crônica/urina , Fatores Etários , Análise de Variância , Biomarcadores/urina , Creatinina/sangue , Creatinina/urina , Progressão da Doença , Taxa de Filtração Glomerular , Valor Preditivo dos Testes , Padrões de Referência , Valores de Referência , Diálise Renal , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/fisiopatologia , Reprodutibilidade dos Testes , Fatores de Risco , Fatores Sexuais , Estatísticas não ParamétricasRESUMO
The role of lead (Pb) as an environmental cause of nephropathy is difficult to ascertain due to the difficulty to determine clinically its exposure. Aim: To assess lead levels and renal function in a group of males working in mechanical workshops. Material and Methods: Blood and urine samples were obtained from 100 mechanical workshop workers aged 38 ± 16 years and 95 non-exposed office clerks aged 37 ± 17 years. Blood lead and creatinine levels were determined. In exposed workers, urinary excretion of intestinal alkaline phosphatases (IAP) and N-acetyl-glucosaminidase (NAG) were measured as early markers of renal failure. Results: Blood lead levels were 66.4 ± 43 and 33.6 ± 18 µg/L among mechanical workshop workers and non-exposed controls, respectively, p < 0.01. The figures for serum creatinine were 0.9 ± 0.1 and 0.9 ± 0.1 respectively, p = NS. Among exposed workers urinary excretion of IAP was 0.47 ± 0.6 U/L and of NAG, 0.92 ± 1.1 U/L. There was a positive correlation between blood lead levels and NAG excretion (r = 0.284) and IAP excretion (r = 0.346). Conclusions: Exposed workers had higher blood lead levels and there was a weak positive association between these levels and the urinary excretion of NAG and IAP.
Assuntos
Humanos , Masculino , Adulto , Exposição Ocupacional/efeitos adversos , Creatinina/sangue , Insuficiência Renal/induzido quimicamente , Chumbo/sangue , Acetilglucosaminidase/urina , Biomarcadores/sangue , Estudos de Casos e Controles , Fosfatase Alcalina/urina , Insuficiência Renal/diagnóstico , Chumbo/efeitos adversosRESUMO
Objectives: Men who have sex with men are at risk of tenofovir nephrotoxicity due to its wide use in both treatment and prophylaxis for human immunodeficiency virus infection, but little is known about the urinary biomarkers of early renal dysfunction in this population. This study aims to identify useful biomarkers of early renal dysfunction among human immunodeficiency virus-infected men who have sex with men exposed to tenofovir.Methods: In a cross-sectional study urinary alpha1-microglobulin, beta2-microglobulin, N-acetyl-B-n-glucosaminidase and albumin were measured and expressed as the ratio-to-creatinine in 239 human immunodeficiency virus-infected men who have sex with men who were treatment naïve or receiving antiretroviral therapy with tenofovir-containing or non-tenofovir-containing regimens. Additionally, 56 patients in the non-antiretroviral therapy group started a tenofovir-containing regimen and were assessed after 3 and 6 months on antiretroviral therapy.Results: Both the frequency of alpha1-microglobulin proteinuria (alpha1-microglobulin-creatinine ratio >25.8 mg/g) and the median urinary alpha1-microglobulin-creatinine ratio were higher in the tenofovir disoproxil fumarate group than the other two groups (all p< 0.05). A higher frequency of beta2-microglobulin proteinuria (beta2-microglobulin-creatinine ratio >0.68 mg/g) was also observed in the tenofovir group (28.9%) compared to the non-tenofovir group (13.6%, p= 0.024). There were no significant differences between groups for N-acetyl-β-n-glucosaminidase and albumin. In the longitudinal study, the median urinary alphat-microglobulin-creatinine ratio after 3 and 6 months on tenofovir-containing therapy (16.8 and 17.3 mg/g) was higher than baseline (12.3 mg/g, p= 0.023 and 0.011, respectively), while no statistically important changes were observed in urinary beta2-microglobulin-creatinine ratio or in the other biomarkers after 3 and 6 months on antiretroviral therapy (all p> 0.05).Conclusion: Urinary alphat-microglobulin seems to be a more sensitive and stable indicator of tubular dysfunction than urinary beta2-microglobulin for assessing tenofovir-related nephrotoxicity and can be significantly altered after tenofovir exposure.
Assuntos
Adulto , Humanos , Masculino , Nefropatia Associada a AIDS/induzido quimicamente , alfa-Globulinas/urina , Homossexualidade Masculina , Túbulos Renais Proximais , Tenofovir/efeitos adversos , /urina , Nefropatia Associada a AIDS/diagnóstico , Nefropatia Associada a AIDS/urina , Acetilglucosaminidase/urina , Albuminúria/induzido quimicamente , Biomarcadores/urina , Estudos Transversais , Estudos Longitudinais , Tenofovir/uso terapêuticoRESUMO
Objective To evaluate the clinical usefulness of urinary N-acetyl-beta-D-glucosaminidase (NAG) excretion for the detection of early tubular damage in type 2 diabetes mellitus (T2DM). Subjects and methods Thirty six patients with T2DM were divided into two groups based on urinary albumin to creatinine ratio (ACR): normoalbuminuria (ACR <30 mg/g; n=19) and microalbuminuria (ACR =30‐300 mg/g; n=17). The following parameters were determined in both groups: urinary NAG and albumin, serum and urine creatinine, fasting plasma glucose and glycated hemoglobin (HbA1c). Results Urinary NAG levels [Units/g creatinine; median (range)] were significantly increased in microalbuminuria group [17.0 (5.9 - 23.3)] compared to normoalbuminuria group [4.4 (1.5 - 9.2)] (P<0.001). No differences between groups were observed in fasting glucose, HbA1c, serum creatinine levels and estimated glomerular filtration rates (eGFR). Urinary NAG positively correlated with ACR (r=0.628; p<0.0001), while no significant association was observed between NAG and glycemia, HbA1c, serum creatinine and eGFR. Conclusions The increase of urinary NAG at the microalbuminuria stage of diabetic nephropathy (DN) suggests that tubular dysfunction is already present in this period. The significant positive association between urinary NAG excretion and ACR indicates the possible clinical application of urinary NAG as a complementary marker for early detection of DN in T2DM. .
Objetivo Avaliar a utilidade clínica da excreção urinária da N-acetil-beta-D-glucosaminidase (NAG) para a detecção de dano tubular precoce no diabetes melito tipo 2 (DM2). Sujeitos e métodos Foram estudados trinta e seis pacientes com DM2 que se dividiram em dois grupos com base na excreção urinária de albumina (EUA): normoalbuminúrico (EUA <30 mg/g de creatinina; n=19) e microalbuminúrico (EUA =30‐300 mg/g de creatinina; n=17). Em ambos os grupos foram determinados os seguintes parâmetros: NAG e albumina urinária, creatinina sérica e urinária, glicemia de jejum e hemoglobina glicada (HbA1c). Resultados Os níveis de NAG urinária [unidades/g de creatinina; mediana (intervalo interquartílico)] foram significativamente maiores no grupo microalbuminúrico [17,0 (5,9 - 23,3)] em comparação com o grupo normoalbuminúrico [4,4 (1,5 - 9,2)] (p<0,001). Não se observaram diferenças significativas entre os dois grupos nos níveis de glicemia de jejum, HbA1c, creatinina sérica e taxa de filtração glomerular estimada (TFGe). A NAG urinária se correlacionou positivamente com o EUA (r=0,628, p<0,0001), não sendo observada associação significativa da NAG com glicemia, HbA1c, creatinina sérica e TFGe. Conclusões O aumento da NAG urinária na fase de microalbuminúria da nefropatia diabética (ND) sugere que a disfunção tubular já está presente nesse período. A associação positiva significativa entre a excreção urinária da NAG e EUA indica a possível aplicação clínica da NAG urinária como marcador complementar para a detecção precoce da ND no DM2. .
Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Acetilglucosaminidase/urina , Albuminúria/urina , /urina , Nefropatias Diabéticas/diagnóstico , Túbulos Renais , Biomarcadores/urina , Glicemia/análise , Colorimetria , Estudos Transversais , Creatinina/sangue , Creatinina/urina , /complicações , Nefropatias Diabéticas/complicações , Nefropatias Diabéticas/urina , Taxa de Filtração Glomerular/fisiologia , Hemoglobinas Glicadas/análise , Túbulos Renais/lesõesRESUMO
OBJETIVO: Este estudo teve como objetivo averiguar a atividade enzimática da N-acetil-β-D-glicosaminidase (NAG) como possível biomarcador precoce de disfunção renal para a exposição ocupacional ao chumbo inorgânico. MATERIAIS E MÉTODOS: Foi selecionado um grupo de 30 pessoas do sexo masculino expostas ao chumbo inorgânico em uma fábrica de baterias localizada no estado do Paraná. Fizeram parte do grupo os funcionários que mostraram valores de chumbo sanguíneo inferiores a 40 mg/dl. O grupo controle foi representado por 15 adultos saudáveis com similaridade em relação à idade e ao gênero do grupo exposto. Foram determinados os níveis de plumbemia, do ácido d-aminolevulínico urinário e a atividade da NAG urinária. RESULTADOS E DISCUSSÃO: Foi evidenciado que a atividade urinária da NAG foi significativamente maior (p < 0,05; teste U de Mann-Whitney) no grupo exposto ao chumbo inorgânico quando comparado ao grupo controle, e houve uma correlação negativa com significância (p < 0,05; correlação de Spearman Rank Order) entre o indicador biológico de exposição plúmbica e a atividade urinária da NAG. CONCLUSÃO: Os resultados demonstraram que o aumento da atividade urinária da NAG pode ser utilizado como um biomarcador precoce da exposição ao chumbo inorgânico.
OBJECTIVE: This study aimed to verify the enzymatic activity of N-acetyl-β-D-glucosaminidase (NAG) as a possible early biomarker of renal dysfunction due to occupational exposure to inorganic lead. MATERIALS AND METHODS: We selected a group of 30 males that had been exposed to inorganic lead in a battery factory in the state of Paraná. This group comprised those employees whose blood lead levels were below 40 mg/dl. The control group consisted of 15 healthy adults of similar age and gender compared with the exposed group. Blood lead concentrations, d-aminolevulinic acid levels and urinary NAG activity were measured. RESULTS AND DISCUSSION: It was shown that urinary NAG activity was significantly higher (p < 0.05, U test of Mann-Whitney) in the exposed group in comparison to the control group, and there was a significant negative correlation (p < 0.05, Spearman Rank Order correlation) between the biological indicator of lead exposure and urinary NAG activity. CONCLUSION: The results showed that the increase of urinary NAG activity may be used as an early biomarker of the exposure to inorganic lead.
Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Acetilglucosaminidase/análise , Acetilglucosaminidase/urina , Acetilglucosaminidase , Doenças Profissionais/diagnóstico , Diagnóstico Precoce , Biomarcadores/análise , Biomarcadores/urina , Nefropatias/diagnóstico , Nefropatias/enzimologia , Ácido Aminolevulínico/análise , Ácido Aminolevulínico , Creatinina/análise , Intoxicação por Chumbo/diagnóstico , Intoxicação por Chumbo/sangue , Intoxicação por Chumbo/urinaRESUMO
OBJECTIVE: Hydronephrosis leads to deterioration of renal function. As urinary N-acetyl-beta-D-glucosaminidase (U-NAG) activity is considered a sensitive marker of renal tubular impairment, our aim was to measure U-NAG in children with hydronephrosis and to look for a relationship among selected clinical parameters. MATERIALS AND METHODS: We studied 31 children (22 boys and 9 girls, mean age 2.3 ± 2.5 years) with hydronephrosis grade 1-4 that had U-NAG/creatinine ratio (U-NAG/Cr) measured. RESULTS: The U-NAG/Cr was significantly higher in patients with hydronephrosis compared to reference data (p = 0.002). There was no difference in U-NAG/Cr between children with unilateral and bilateral hydronephrosis (p = 0.51). There was no significant difference in U-NAG/Cr between children with grades 1-3 (pooled data) and grade 4, respectively (p = 0.89). There was no correlation between U-NAG/Cr and the grade of hydronephrosis (r = 0.01). CONCLUSIONS: U-NAG/Cr is increased in children with hydronephrosis grade 1-4, and there is no relationship with the grade of hydronephrosis. U-NAG is a useful marker of renal tubular dysfunction, however its relationship with the degree of kidney damage in patients with hydronephrosis should be considered as doubtful.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Acetilglucosaminidase/urina , Hidronefrose/urina , Túbulos Renais/fisiopatologia , Biomarcadores/urina , Hidronefrose/enzimologia , Hidronefrose/fisiopatologia , Índice de Gravidade de DoençaRESUMO
OBJECTIVE: Renal tubular damage can be assessed with the aid of urinary dosing of N-acetyl-beta-glucosaminidase (NAG) and it is possible to demonstrate a significant correlation between shock wave and damage to renal parenchyma. The objective of this study was to assess the effect of shock wave reapplication over urinary NAG in canine kidney. MATERIALS AND METHODS: The authors submitted 10 crossbred dogs to 2 applications of 2000 shock waves in a 24-hour interval in order to assess urinary NAG values after 12, 24, 36 and 48 hours. RESULTS: Twelve hours following the first shockwave application there was an increase in NAG of 6.47 ± 5.44 u/g creatinine (p < 0.05). Twelve hours and 24 h following the second application there was no increase in the urinary enzyme, - 2.56 ± - 7.36 u/g creatinine and 2.89 ± - 7.27 u/g creatinine, respectively (p > 0.05). CONCLUSION: Shock wave reapplication with a 24-hour interval did not cause any increase in urinary NAG.
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Animais , Cães , Acetilglucosaminidase/urina , Rim/lesões , Litotripsia/efeitos adversos , Rim/metabolismoRESUMO
Es controversial determinar la magnitud del posible daño del parénquima renal secundario a las ondas de choque utilizadas en litotripsia extracorpórea (LEC). La elevación urinaria de la actividad de la enzimaN-acetil-ß-D-glucosaminidasa (NAG) puede reflejar este daño y su evolución en el tiempo. El objetivo de este estudio será precisar la magnitud y duración del daño renal posterior a LEC, a través de mediciones de NAG y su correlación con algunos parámetros clínicos. Se realizó un estudio prospectivo en 15 pacientes, de ambos sexos, portadores de litiasis renal única, sin otra patología renal asociada. Se determinó la actividad urinaria de NAG antes y 1, 7 y 30 días post LEC. Se midió la relación entre NAG (U/L) y creatinina (mmol/L) urinarias, expresada como índice NAG (U/mmol). Se consideró su relación con: a) tamaño, b) ubicación y c) número de impactos utilizados. Paralelamente, se determinó NAG urinario como referencia en 5 pacientes sanos y en un portador de daño tubular renal. En 7 de 15 pacientes, se verificó un incremento en el índice NAG al día siguiente de la LEC, regresando a valores basales, en la mitad de los casos, al cabo de una semana. Esta elevación fue menor comparada con la observada en el paciente con daño renal. No se encontró diferencias entre el número de impactos y ubicación de la litiasis, con el valor del índice NAG. Cinco de siete pacientes que presentaron alza enzimática tenían litiasis mayor a 1 cm. Se puede señalar que la LEC produce cierto grado de daño renal, aunque de baja magnitud, variable, reversible a corto plazo y asociado al tamaño de los cálculos, similar a lo descrito en la literatura. Si bien la muestra empleada es pequeña para determinar diferencias estadísticamente significativas, nuestra investigación aparece como un informe preliminar para objetivar el potencial daño renal post-LEC y permitirá evaluar la implementación de esta técnica de medición en el futuro.
Assuntos
Humanos , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Cálculos Renais/terapia , Litotripsia/efeitos adversos , Rim/efeitos da radiação , Acetilglucosaminidase/urina , Acetilglucosaminidase , Creatinina/urina , Necrose Tubular Aguda/etiologia , Estudos ProspectivosRESUMO
Esta investigación pretendió establecer los efectos del Hg sobre la salud de odontólogos y asistentes dentales, su relación con condiciones de exposición, y el posible daño renal debido al Hg. La población fue de 66 personas, la muestra, 37 (56 por ciento), 22 odontólogos (59,5 por ciento, 19 hombres, 3 mujeres) y 15 asistentes dentales mujeres (40,5 por ciento). Se realizaron: encuesta opcional, Hg en orina (Hg-O) y actividad de N-Acetil-beta-D-glucosaminidasa en orina (BAG-O), como biomarcador precoz de daño renal. Los valores de HgO para los odontólogos fueron 22.4 más o menos 6,4 micra g/g creatinina, para los asistentes, 22,2 más o menos 6,1 mu g/g creatinina (p>0.05), y los de BAG-O, de 2,9 más o menos 3 U/L y de 5,2 más o menos 8,1 U/L, respectivamente, no existiento diferencias estadísticamente significativas (p0,05). No se detectó correlación entre el námero de amalgamas preparadas y de horas trabajadas con Hg-O y NAG-O. Los síntomas más frecuentes referidos por los odontólogos fueron irritabilidad, 54,5 por ciento, cefalea, 45,4 por ciento y artralgias, 40,9 por ciento. Por los asistentes, artralgia, 53,5 por ciento, irritabilidad, 46,7 por ciento, y cefalea, 46,7 por ciento, no existiendo riesgo significativo de sufrirlo para ningún grupo. Se requieren nuevas investigaciones que incluyan monitoreo ambiental del Hg, evaluación médica y pruebas neuroconductuales para detectar efectos precoces, asá como la aplicación de medidas de control en pro de la salud del personal.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Exposição Ocupacional , Odontologia , Mercúrio/efeitos adversos , Acetilglucosaminidase/metabolismo , Acetilglucosaminidase/urina , Venezuela/epidemiologia , Humor Irritável , Biomarcadores/urina , Artralgia/induzido quimicamente , Artralgia/epidemiologia , Amálgama Dentário , Cefaleia/induzido quimicamente , Cefaleia/epidemiologia , Rim/patologia , Mercúrio/urinaRESUMO
Determinaram-se as atividades de duas enzimas de membrana: alanina-aminopeptidase (AAP), -glutamil-transpeptidase e da enzima lisossomal N-acetil-B-D-glucosaminidase, os níveis de proteína total, albumina e ácido delta-aminolevulínico em urinas de indivíduos expostos ocupacionalmente ao chumbo e de indivíduos näo expostos. Todos os indivíduos apresentavam creatinina sérica inferior a 1,5 mg/dl. Foram determinados os níveis sangüíneos de chumbo e aferidas pressäo arterial diastólica e pressäo arterial sistólica. Objetivou-se investigar a toxicidade renal crônica do chumbo e sua possível correlaçäo com a pressäo arterial em indivíduos com funçäo renal normal. A pressäo arterial diastóeca foi maior no grupo exposto. Observaram-se correlaçöes das pressöes com tempo de exposiçäo e com chumbo no sangue